Interleukin 12 (IL-12) for the Treatment of Cryptosporidiosis in AIDS Patients

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00057486
Recruitment Status : Terminated
First Posted : April 3, 2003
Last Update Posted : December 14, 2016
Information provided by:
National Institute of Allergy and Infectious Diseases (NIAID)

Brief Summary:
There is no proven effective treatment for chronic diarrhea caused by the parasite Cryptosporidium in advanced AIDS. This trial will test the safety of interleukin-12 (IL-12) as part of a combination therapy for this parasite.

Condition or disease Intervention/treatment Phase
HIV Infections Cryptosporidiosis Drug: IL-12 Phase 1 Phase 2

Detailed Description:

Cryptosporidium parvum can cause chronic diarrhea and biliary disease in people with AIDS, resulting in significant morbidity and mortality. Highly effective antiparasitic treatment for this infection is not currently available. Paromomycin and azithromycin have some efficacy and have been used in combination in a small number of patients. However, in clinical trials of this drug combination, patients remained infected with the parasite despite improvement of their symptoms.

Improving the immune system with highly active antiretroviral therapy (HAART) has been the most effective therapy described for cryptosporidiosis (chronic infection with Cryptosporidium parvum), with over 80% of patients showing improvement. However, immune reconstitution is not possible in all patients.

Interferon gamma expression is strongly associated with control of cryptosporidiosis. IL-12 stimulates interferon gamma, and IL-12 treatment has been shown to prevent cryptosporidiosis in mice. This study will evaluate IL-12 in combination with standard therapy for cryptosporidiosis in patients with AIDS.

This is a dose-escalation study. All patients will be treated with paromomycin and azithromycin. The initial group will be treated with either 110 ng/kg IL-12 (6 patients) or placebo injections (2 patients) twice a week for 4 weeks. If the initial dose is ineffective and the combination of drugs is tolerated, a second group of patients will be randomized to either 300 ng/kg IL-12 (6 patients) or placebo injections (2 patients) twice a week for 4 weeks. Patients will be evaluated for eradication of the parasite (as measured by immunofluorescence and intestinal biopsy), decreases in stool frequency, decreases in 24 hour stool volume, stimulation of intestinal Th1 cytokine production, increases in body weight, improvements in Karnofsky score, and improvements in serum alkaline phosphatase levels and transaminases (if elevated at baseline).

Study Type : Interventional  (Clinical Trial)
Enrollment : 2 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double
Primary Purpose: Treatment
Official Title: A Pilot, Proof-of-Concept, Dose-Escalating Trial of Recombinant Human Interleukin-12 (rhIL-12) Versus Placebo Along With Paromomycin and Azithromycin for Chronic Cryptosporidiosis in AIDS
Study Start Date : September 1997
Actual Primary Completion Date : June 2005
Actual Study Completion Date : June 2005

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion criteria:

  • HIV infection
  • CD4 cell count < 150 cells/µl
  • Stable antiretroviral regime that includes at least two nucleotide analogues for at least 4 weeks
  • Viral load < 10,000 copies/ml
  • Chronic diarrhea, defined as three loose or watery bowel movements a day for 5 days per week over 3 weeks
  • Stool positive for Cryptosporidium and no other enteric pathogen (bacterial culture, C. difficile toxin assay, AFB stain, ova and parasite examination, and stain for microsporidia)
  • Karnofsky score >= 70
  • Acceptable methods of contraception

Exclusion Criteria:

  • Pregnant
  • Active opportunistic infection
  • History of hypersensitivity or significant intolerance to aminoglycosides, macrolide antibiotics, or colony stimulating factors
  • Requires intravenous fluids

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00057486

Sponsors and Collaborators
National Institute of Allergy and Infectious Diseases (NIAID)
Principal Investigator: Arthur White Baylor College of Medicine Identifier: NCT00057486     History of Changes
Other Study ID Numbers: 2R01AI041735-04A2 ( U.S. NIH Grant/Contract )
5R01AI041735-05 ( U.S. NIH Grant/Contract )
First Posted: April 3, 2003    Key Record Dates
Last Update Posted: December 14, 2016
Last Verified: March 2003

Keywords provided by National Institute of Allergy and Infectious Diseases (NIAID):
Chronic Diarrhea
Interleukin 12

Additional relevant MeSH terms:
HIV Infections
Lentivirus Infections
Retroviridae Infections
RNA Virus Infections
Virus Diseases
Sexually Transmitted Diseases, Viral
Sexually Transmitted Diseases
Immunologic Deficiency Syndromes
Immune System Diseases
Intestinal Diseases, Parasitic
Parasitic Diseases
Protozoan Infections, Animal
Parasitic Diseases, Animal
Protozoan Infections
Intestinal Diseases
Gastrointestinal Diseases
Digestive System Diseases
Adjuvants, Immunologic
Immunologic Factors
Physiological Effects of Drugs
Angiogenesis Inhibitors
Angiogenesis Modulating Agents
Growth Substances
Growth Inhibitors
Antineoplastic Agents